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Effects of bupropion augmentation on pro-inflammatory cytokines in escitalopram-resistant patients with major depressive disorder

Department of Psychiatry, University of Tartu, Tartu, Estonia

V Vasar

Department of Psychiatry, University of Tartu, Tartu, Estonia

J Shlik

Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada

E Maron

Department of Psychiatry, University of Tartu, Tartu, Estonia; The North Estonian Regional Hospital, Psychiatry Clinic, Tallinn, Estonia Eduard.Maron{at}kliinikum.ee

Abstract

Studies so far have provided contradictory results on immune system markers during use of antidepressants. There are no data on changes in immune parameters after treatment augmentation. The present study aimed to clarify whether the addition of bupropion in escitalopram-resistant patients with major depression causes changes in the immune system and whether treatment response could be predicted by baseline levels of cytokines. We recruited 28 depressive patients (11 men and 17 women) who did not respond to 12-week treatment with escitalopram (20 mg/d) for an augmentation trial with bupropion (150–300 mg/day). The levels of soluble interleukin-2 receptor, interleukin-8 (IL-8) and tumor-necrosis factor- were measured before and 6 weeks after addition of bupropion. For a control group, we recruited 45 healthy volunteers (19 men and 26 women). The results indicated that the baseline levels of studied cytokines did not predict treatment response to bupropion augmentation. Concentration of IL-8 increased during the treatment similarly in both responder and non-responder groups. Although bupropion augmentation had increased the response rate in escitalopram-resistant patients, this clinical improvement was not accompanied by specific changes in studied cytokine levels.

Key Words: bupropion • escitalopram • interleukin-8 • major depression • soluble interleukin-2 receptor • tumor necrosis factor-

This version was published on September 1, 2009

Journal of Psychopharmacology, Vol. 23, No. 7, 854-858 (2009)
DOI: 10.1177/0269881108091077


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